TOP TIPS ON HOW TO MANAGE ARTHRITIS PAIN…

5 top tips on how to manage arthritis from your home from consultant orthopaedic surgeon Mr Faisal Hussain from BMI The Priory and BMI The Edgbaston hospitals.

Mr Hussain explains that ‘more than 10 million people in the UK are living with arthritis.‘ His five top tips to improve your health and quality of life, allowing you to live better with arthritis are :

1. Keep Active

2. Get a good night’s sleep

3. Look after your mental well-being

4. Eat for health

5. Maintain a healthy weight

For a more detailed description of how to manage the above tips go to the BMI website here.

Everyday Health say some lifestyle changes can help you manage pain and they include the same tips as above but also say Get vitamin C. Studies have shown that vitamin C may be helpful in managing inflammation in the body. So dig into an orange or pour yourself a glass of grapefruit juice each day.

They also say Avoid alcohol. Don’t medicate yourself with alcohol to manage pain; it will only create more problems, and add calories to your diet.

Healthline suggest trying hot and cold therapy (details on this on their website), try acupuncture or meditation and include the right fatty acids for your diet. Everyone needs omega-3 fatty acids in their diet for optimum health. These fats also help your arthritis. Fish oil supplements, which are high in omega-3s, have been shown to reduce joint stiffness and pain. Also try adding turmeric to your recipes.

Another tip is to get a massage. According to the Arthritis Foundation, regular massaging of arthritic joints can help reduce pain and stiffness and improve your range of motion. Work with a physical therapist to learn self-massage, or schedule appointments with a massage therapist regularly.

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SUCCESS RATES OF AN EPIDURAL STEROID OR FACET JOINT INJECTIONS FOR BACK PAIN?…

With so many different types of spinal injections available for back pain I decided to do a bit of research on epidurals for back pain and what I had for my cervical pain back in March this year.

I was told at the time that the way I had this injection (which was through the front of my neck ) was highly dangerous and that not many pain consultants ( including mine) would perform this procedure. All the way through the procedure the consultant ( another one I had been referred to who specialised in this type of injection )kept saying I must not move one fraction of an inch but instead to shout stop whenever I started to feel it too uncomfortable.

Right from when start when the injection went in I instinctively moved slightly because of the discomfort and the consultant was quite strong in his words to remind me to say stop or he may have to stop the whole procedure.

Slowly but surely after numerous stops I was given a fair dose of the steroid to help with my pain. I then had strict instructions on how I might feel afterwards and if I felt differently to phone directly to speak to him.

I can honestly say it wasn’t the most pleasant or procedures but I’m always of the opinion of no pain no gain with these type as of procedures. Fortunately I had no after affects and after about three weeks ( I was told it could take that long) the pain relief kicked in and my neck and arm pain disappeared for the first time in years.

When I asked the consultant how many of this particular type of injection I could have in a year he said he would not recommend ever having another as it is so dangerous.

The pain relief lasted four amazing months !

Spine Health wrote that while the effects of an epidural steroid injection tend to be temporary (lasting from a week to up to a year) an epidural steroid injection can deliver substantial benefits for many patients experiencing low back pain.

  • Recent research reports that lumbar epidural steroid injections are successful in patients with persistent sciatica from lumbar disc herniation, with more than 80% of the injected group with disc herniation experiencing relief (in contrast to 48% of the group that received a saline placebo injection).
  • Similarly, in a study focused on a group of patients with lumbar spinal stenosis and related sciatica symptoms, 75% of patients receiving injections had more than 50% of pain reduction one year following the injections. The majority also increased their walking duration and tolerance for standing.

So, I could see from this information that it seems to be ok for lumber pain but there is no mention of it for cervical pain.

An article in The Daily Mail said that tens of thousands of patients are being given a ‘useless’ back-pain injection, which costs the NHS nearly £40 million every year, an analysis suggests.

Patients that demand a ‘quick fix’ for their discomfort are being given the treatment, priced at £540 per procedure, despite doctors being told to recommend back-pain sufferers be more active or try psychological therapy.

According to an analysis of NHS data by The Times, 70,608 steroid injections into patients’ facet joints, which make spines flexible, occurred last year, compared to 62,570 five years ago.

Guidelines released in both 2009 and 2016 advise against the procedure. 

Figures also show 8,044 operations that fuse spinal bones together were carried out last year, up from 7,224 between 2012 and 2013. 

Spinal Healthcare point out that Epidural steroid injections are actually very safe, since they are simply an injection that contains both local anaesthetic and steroids. In effect these reduce the inflammation that is causing pain in the nerves and the disc in the spin and the local anaesthetic numbs the area, bringing short term numbness to the region. By the time the local anaesthetic wears off the steroid will be working to reduce inflammation.

However there are some risks with the procedure, but these need to be looked at in context. Almost every human activity carries some risk with it. For example, crossing the road, lifting heavy objects, even opening a tin of beans all carry risks. Yet we do them every day, simply because they are necessary to human function.

Reading through lots more posts on epidurals I have come to the conclusion that like anything in life one size does not fit all of us and for some this treatment gives great relief and for others none whatsoever. There is definitely a problem with the cost of this type of injection as you require x ray staff and others to proceed with it. My facet joint injections which were also done in X-ray were cut a couple of years ago due to funding.

I can quite understand the cuts as the NHS is under so much pressure but I think it would make sense to have a team of people who simply follow up your pain relief after the injection to monitor if it was worth doing or not. That way the ones who benefit could continue having them and and the ones that don’t could try something else.

As far as the safety of this type of injection, I guess any injection into your spine carries risks but that could apply to any type of procedure. However, having it for cervical pain is something I could not find so it makes me think that maybe the one I had was a one off that worked for a while but now it’s back to square one again.

 
 
 

TIPS ON HOW TO AVOID COMMON CAUSES OF BACK PAIN…

So many things can cause you back pain, in fact far to many to list but I found a few tips on how to avoid the most common causes of back pain.

Standing incorrectly I suppose is an obvious one but they say that if you can avoid leaning while standing (against a wall or similar) and do not stand on one leg as this can create muscle imbalances.

Sitting incorrectly while driving can soon cause back pain, they suggest that you should raise your seat up until your hips are level with your knees. Raise it higher if you can’t see clearly out the windshield or windows. Don’t drive with your hips lower than your knees. If your car doesn’t have a control to adjust the seat height, then sit on a cushion to help keep your hips level with your knees. I have a coccyx cushion in my car and my husbands car and could not last a journey without one.

For women they say your bra is very important, which is something I have written a little bit about before. Apparently London’s Royal Free Hospital says that 100% of women who want a breast reduction is because they are suffering from back pain and most of them were found to be wearing the wrong sized bra. I think its easier now as most department stores have fully trained staff to measure you properly.

Sitting at your computer is a very important one. They say its because you have to lean forward or stretch out with your arms, both of which can cause back ache. To stop this happening they recommend that you set your keyboard so you rest your arms on the desk to use it, and your screen so that your head is straight when you look at it. My son bought me a special ergonomic key board and computer mouse for when I sit at my desk and worked out the correct height for my laptop which sits on some books and I do feel I can sit a little longer now that is right.

They also say sitting too much can cause back pain as apparently when you sit down, the load going through your discs is increased threefold so they recommend that you move regularly, ideally every 20 minutes. Well I’m afraid I do sit most of the time but my legs are always horizontal ( not sure if that helps) but as I do get uncomfortable often I do have to move around quite a bit so hopefully at least I am doing that right.

Low vitamin D levels was quite a shock for me as I haven’t once been told to take any form of supplement for my back. They say it is because deficiencies in the sunshine vitamin D are now strongly linked to back pain which they say is because insufficient vitamin D makes surfaces on your spine soft and spongy, which then irritates the nerves. Their top tip is to take a supplement of vitamin D.

One for the girls ( and some boys) they say high heels causes back pain due to the way they tilt your pelvis forward, they suggest alternate heel heights so no need to throw all those beautiful heels away, just don’t wear them all the time.

Some of the most obvious things to avoid as they can cause back pain are:

  • Lifting incorrectly
  • Overstretching during lifting, bending or twisting
  • Bad posture
  • Poor sleeping position or a sagging mattress
  • Lack of exercise

With increased risk factors of back pain being:

  • Being overweight
  • Pregnancy
  • Smoking

MY TOP THREE PILLOWS FOR THE DISCOMFORT OF BACK AND NECK PAIN…

Pillows are so personal don’t you think? After my first cervical surgery I had to wear a collar so it didn’t really matter what pillow I had but after the second cervical fusion they did not advise one but neither did they advise any type of pillow, so I stuck with the same soft type for years. So much so that when I go to a Hotel and the pillow is hard I find it very difficult to get to sleep.

However, they have now found out that certain neck pillows can not only help with the pain from disc injuries and whiplash but also for back pain, shoulder pain and even chronic pain.

There are obviously quite a few different types advertised and the tempa ones are advertised everywhere. When I go for my afternoon rest I always just get under the throw and sleep on my v pillow, on my side whereas when I got to bed at night I sleep on a fairly flat a pillow which would not suit most people but after two cervical fusions my neck is pretty stiff so I cannot cope with anything too thick. My other problem is that although I know I should sleep on my side or on my back I love going to sleep on my front which is the worst position for neck and back problems.

My top three choices are –

Sealy Activsleep Geltex Memory Foam Pillow, Amazon, £34.99

This pillow focuses on ventilation and airflow which runs between the hundreds of tiny fibres that surround the Geltex core so it has lots of breath ability. It’s great for allergy sufferers in mind too, with hypoallergenic filling and a knitted Purotex cover to prevent bugs and bacteria.

I personally found this too high for myself but my husband who usually has two pillows found this one pillow enough for him and extremely comfortable. I did struggle getting it into a regular size pillow case, though.

  • Sealy Activsleep Geltex Pillow standard size 74 x 48cm
  • Made with a supportive and comfortable memory foam shell that is ventilated to increase airflow and breathability and prevent overheating
  • The revitalising Geltex core provides support, comfort and coolness and is surrounded by DuPont Cotrano fibres which are light and bouncy
  • Knitted Purotex cover helps to combat pillow nasties such as bugs and bacteria
  • Made in the UK, anti-allergenic, 2 year manufacturer’s guarantee

My second choice is The White Company Memory Foam Comfort Pillow which is £45

This special shape-contouring pillow is made with shredded memory foam, which means it gives fantastic firm support with added comfort. The beauty of this design is that it gives the supportive benefits of memory foam, while boasting the sleek appearance of a traditional pillow. If you sleep on your side, this pillow will bridge the gap between your shoulder and neck for perfect alignment. What’s more, the soft casing can be unzipped and machine washed at 40°C, making it wonderfully easy to care for.

Firm support
Non-Allergenic 
Filling: 100% memory foam clusters

I LOVE this pillow but then I love just about everything at The White Company. It fitted perfectly into a normal size pillow case and feels more like a normal luxury pillow rather than a memory foam pillow, which is why I think I like it so much.

It’s better for side sleepers, which I should be but prefer to sleep on my stomach and it definitely bridges the gap between your shoulder and neck for correct alignment. I love that it can be unzipped and popped into the washing machine.

My third choice is Soak and Sleep’s soft Duck Feather and Down pillows are a delightful way for front sleepers to nod off, from £20.

It feels substantial thanks to the generous quantity of small, soft duck feathers blended with light and lofty duck down, and is very reasonably priced too. You can choose between a soft/medium pillow – ideal for front sleepers or a deeper medium/firm pillow that’s better suited to side and back sleepers.

This pillow will support your head and neck for good spinal alignment – you can choose from their range of pillow fills, firmnesses and depths to suit your sleeping style.

Covered with a 233 thread count percale to help wick away moisture for a cooler, more refreshing night’s sleep. It’s another pillow that can be machine washed.

You can choose between a soft/medium pillow – ideal for front sleepers or a deeper medium/firm pillow that’s better suited to side and back sleepers. Obviously I chose the soft/medium pillow.